My mom, 68 y/o, was diagnosed with severe UC in May, after having weathered flare-ups for 7 years. Her most recent flare started in October last year, and she kept trying to fight it as she always has, but this time it didn't go into remission.

She's been in the hospital for the past 7 weeks, getting treatment for UC as well as its complications: severe malnourishment, electrolyte imbalances, etc. In May she had a scary episode of prednisone-induced psychosis, which resulted in her first hospitalization. She was taken off pred and seemed to recover reasonably from that, but the UC was worse than ever when she was admitted again in late June.

Her hospital doctor (not a GI specialist) diagnosed her with dementia, as well as a host of other psychiatric problems: major depression, generalized anxiety disorder, adjustment disorder (owing to her severe UC), and possibly "pseudodementia", which means (from what I understand) any of the above which can masquerade as "true" dementia.

It's true that her short term memory is severely curtailed. Sometimes she still remembers a name we heard yesterday that I'd already forgotten - her memory and mind have always been very sharp - but mostly she struggles with everything, including the names of her meds, even the ones she's been getting daily for a month or more. I've read elsewhere in this forum that some drugs - prednisone, Xanax, Ativa, and Remicade, all of which (except pred) she gets regularly - have impacted others' memories and/or mental health to some degree. I'm wondering whether what she's going through sounds familiar to anyone.

She had her third weekly methotrexate injection today - her latest attempt at medical therapy.

It's a lot to try to cope with one new major chronic illness, as many of you know, much less two. Any advice would be appreciated.

Paddy, seven weeks in the hospital is a long time. Older people removed from familiar surroundings, bombarded with new sights, sounds, terminology and diseases can become disoriented. Memory problems are not a feature of UC, although severe anemia might lead to them. Prednisone can cause emotional instability ranging from easy crying to rage reactions. Xanax is a sedative and can lead to confusion and memory problems. Often apparent "dementia" is caused by combinations of medications.

If she's being treated for mental health issues, she deserves to be evaluated by a qualified psychiatrist. When dememtia is suspected, evaluation by a psychologist is also indicated. As a former nurse, I know hospitals are quick to medicate people who are unhappy, agitated, confused or just plain complain too much. If she wasn't endangering herself or anyone else before the Xanax was started, I'd request a trial of at least five days off of it to see if her mental status improves. Remicade doesn't cause confusion, and I'm not familiar with Ativa and couldn't find it on the internet. I'd also be interested to see if she did better in her own home, receiving treatment on an outpatient basis.

It could be that your mother is beginning to experience symptoms of dementia, but in fairness to her, other causes for her memory loss need to be ruled out before that diagnosis is made. And if I understand right and the doctor is giving her an "adjustment disorder" diagnosis based on the fact that she has UC, that doctor is an incompetent fool. It's been thirty years since any competent healthcare professional believed UC was caused by a "neurotic personality." If he's saying the adjustment disorder is because of the UC, he needs to check his diagnostic criteria. By definition, adjustment disorder is diagnosed only when other the person does not meet the diagnostic criteria for any other psychiatric disorder - such as depression or anxiety disorder, and when the symptoms are not related to a physical health issue - such as dementia.

See if you can get her checked out by the psychiatrist/psychologist combo. The psychiatrist really only prescribes medicaton. A psychologist can test for cognitive problems and a psychologist or counselor can provide help to her in coping with a difficult diagnosis. Good luck, and I hope she's soon well enough to get home where she's in familiar surroundings.

Judy

Moderate to severe left-sided UC (21 cm) diagnosed 2001.

Avascular necrosis in both shoulders is my "forever" gift from Entocort.

Poor nutrition can also lead to dementia-like symptoms especially in the older population. I think until they get her UC controlled you won't know if her dementia is real or just a side effect of malnourishment. It will be very important for her to maintain good nutrition and since eating might be difficult she should supplement calorie loss with calorie packed beverages. Carnation makes a product that has 300 calories per serving and comes in sugar free or lactose free if she has blood sugar or lactose problems. Make sure you talk with her GI about boosting her calorie intake once she is stabilized.

Thanks for your many, considered insights into the UC/hospitalization experience. They help put things in a more hopeful perspective.

Judy- I meant Ativan, not Ativa. I was told by her doctor (GM) that stopping Xanax abruptly can cause anxious people - as anyone going through seven weeks of hospitalization would be - to become extra anxious, but I did suggest that she try stopping her morning Xanax to see if it would make any difference to her fuzziness. Today was a really good day for her, from what I could see, in terms of her memory and alertness. The adjustment disorder, by the way, that the doc dx'ed meant that the depression/etc. was caused by her colitis, not the other way around. She is seeing a psychologist once a week now, and for the time being seems to want that, though earlier this week she didn't. It's a day-by-day thing.

Sue- She is getting Ensure "shakes", which are calorie and nutrition packed, and she seems to like and digest these pretty well. She may be starting tube feeding, b/c she's still not holding onto her weight (87.1#, down from a normal of 115#). I agree that diet seems to have a big impact on her clarity, and until things resolve further physically it won't really be possible to know exactly what's going on mentally.

"Princesa"- Hopefully the lactobacillus (2 tabs, 4x/d) is helping fix that situation too. She's been on Flagyl for a total of a month, probably, over the past seven weeks, so no doubt her gut ecology is pretty depleted.

Quincy- She's getting folate (B9) and thiamine (B1), but not B12. I think I'd read elsewhere that B12's important for memory and maintaining brain function, especially as we age. I also thought that B-vitamins needed one another to be fully effective, so if she's not getting the others she probably should. I think her Ensure beverages are pretty good for the B's.

I appreciate all your perspectives and advice, and as others have written here before, this forum is really invaluable in helping a person feel that they (or their parent) are not going through it blind, helpless, and alone.